Susceptibility Patterns Of Clinical Isolates Research Articles

Microbial Detection and Antibiotic Susceptibility patterns of Clinical Isolates from Women With Urinary Tract Infection in AL-Nasiriyah City/Iraq

Microbial Detection and Antibiotic Susceptibility patterns of Clinical Isolates from Women With Urinary Tract Infection in AL-Nasiriyah City/Iraq

Study on Prevalence and Antimicrobial Susceptibility Patterns of Clinical Isolates in a Tertiary Care Teaching Hospital

Study on Prevalence and Antimicrobial Susceptibility Patterns of Clinical Isolates in a Tertiary Care Teaching Hospital

Genotype Distribution and Antibiotic Susceptibility Pattern of Clinical Isolates of Group B Streptococcus in a Tertiary Care Hospital in Puducherry, South India.

Streptococcus agalactiae apart from being a colonizer in the genital region is also associated with several other invasive infections in all age groups. With the varied distribution of serotypes across different regions of the world, universal vaccination is also unattainable. However, in India, the knowledge of group B Streptococcus (GBS) genotype distribution is deficient. Thus, this study was initiated to add data on this aspect. Methodology. A cross-sectional study was conducted using isolates of group B Streptococcus from all clinical specimens. Along with that, the clinical specimen type and the antibiotic resistance profile of the isolates were correlated with the genotypes recognized through a multiplex PCR assay. Among the 86 isolates subjected to multiplex PCR for genotype identification, five genotypes were identified with genotype Ib as the predominant one (34.9%), followed by III (20.9%), II (16.3%), Ia (12.7%), and V (11.6%). The results demonstrated a correlation of types Ib and III with vaginal colonization and type II with urine specimens in the current study. This preliminary study exhibited the distribution of common genotypes and their antibiotic resistance profiles in various GBS isolates. However, multiple studies across the country with larger sample sizes are needed to validate these findings.

Multidrug-Resistant and Extremely Drug-Resistant Pseudomonas aeruginosa in Clinical Samples From a Tertiary Healthcare Facility in Nigeria.

Pseudomonas aeruginosa has been globally implicated in healthcare-associated infection. The susceptibility pattern of clinical isolates of P. aeruginosa to anti-pseudomonal antibiotics is reported. Clinical samples, namely blood, urine, tracheal aspirate, cerebrospinal fluid (CSF), wound swabs, high vaginal swabs, eye, and ear exudates were obtained from patients, processed and identified using standard microbiological protocols. Antibiotic susceptibility testing was undertaken using the Kirby Bauer Disc diffusion method. Results were reported following the Clinical and Laboratory Standards Institute guidelines. Of 104 P. aeruginosa isolates identified, males (52.88%) had a higher incidence of infection than female (47.11%) patients. The highest prevalence was recorded from wound swabs [46 (44.23%)] followed by ear exudates [23 (22.12%)], urine [22 (21.15%)], while eye exudates and samples from the CSF yielded the least [1 (0.96% each)]. From the antibiogram, imipenem had the highest antibiotic activity (91.3%) followed by polymyxin B (84.6%). The isolates exhibited the highest resistance to ceftazidime (73.1%) and piperacillin-tazobactam (61.5%). The antibiotic susceptibility pattern of P. aeruginosa isolates revealed 7.69% susceptible, 26% resistant, 61% multidrug resistance (MDR), 5% extremely drug resistance (XDR), and an absence (0%) of pandrug-resistant phenotypes. The study recorded alarmingly high cases of MDR and some XDR phenotypes of P. aeruginosa in University of Port Harcourt Teaching Hospital. It will help identify existing gaps in antimicrobial resistance surveillance and assist in improving public health policies regarding antibiotic stewardship, initiatives, and interventions.

Phenotypic Characterization and Antibiotic Susceptibility Pattern of Clinical Isolates of Enterococci with Special Emphasis on Vancomycin Resistance

Aims And Objectives Primary Objective: To the isolates and identify the enterococci from various clinical specimens. Secondary Objectives: To determine the antibiotics susceptibility pattern of enterococci isolates. Design: Prospective Study Materials And Methods: 65 Clinical samples sent for bacteriological examination and culture sensitivity were taken up in this study. Preliminary findings and identification of Enterococci species was carried out using Gram staining, Catalase test, Bile esculin test and growth in NaCl, followed by Antibiotic sensitivity testing in Muller Hilton Agar. The resistant strains were subjected to agar dilution method, Vancomycin e-strip method and Vitek-2 automated system for phenotypic detection of Vancomycin resistance. The results were observed and analysed. Result: Among 65 clinical specimens analysed, enterococci species were isolated from various specimens. Among which 50 isolates which were identified as E. faecalis from biochemical tests were further analysed for antibiotic susceptibility pattern. Keywords: VRE, Enterococci, Phenotypic methods, Resistance, Enterococci, Speciation, Antibiotic resistance, High level gentamicin, Vancomycin.

Molecular epidemiology of aspergillosis in Magellanic penguins and susceptibility patterns of clinical isolates

Aspergillus section Fumigati is reported in up to 99% of aspergillosis cases in penguins. So far, no data regarding molecular epidemiology and azole resistance are available for A. fumigatus isolates collected from Magellanic penguins. The aim of this work was to perform molecular identification of Aspergillus section Fumigati at species level, to genotype those isolates using microsatellite markers, to evaluate the in vitro susceptibility patterns of A. fumigatus sensu stricto, and to characterize the cyp51A gene in clinical A. fumigatus strains isolated from Magellanic penguins with proven aspergillosis. All 34 isolates included in the study were identified as A. fumigatus sensu stricto. Analyzing the genetic diversity of the isolates of A. fumigatus sensu stricto, we identified two possible outbreaks in the rehabilitation center and we also observed the maintenance of clonal strains through the years. One A. fumigatus sensu stricto isolate was resistant to posaconazole, but the mutations found in the cyp51A gene of this isolate have not been described as conferring phenotypic resistance, suggesting that other mechanisms of resistance could be involved in the resistance of this isolate. With this study, we were able to understand the molecular diversity of Aspergillus fumigatus isolates collected from Magellanic penguins, to characterize them and to associate them with the described global population of Aspergillus fumigatus.

Prevalence of Extended-Spectrum β-Lactamase and Antimicrobial Susceptibility Pattern of Clinical Isolates of Pseudomonas in Tertiary Care Centre of Kutch

Aim: The current research was performed with an aim to discover the prevalence of ESBL producing P. aeruginosa and also to provide as a direct for doctors administration subjects by executing suitable infection control events as well as inventing an efficient antibiotic policy.
 Materials and Methods: The current research was performed in the Department of Microbiology at Gujarat Adani Institute of Medical Science, Bhuj, Kutch, Gujarat over a period for one year. All 250 isolates of Pseudomonas aeruginosa acquired from different clinical samples established in microbiology laboratory from IPD & OPD were incorporated in the research. Different clinical specimens established in our laboratory were coursed and Pseudomonas aeruginosa was recognized as apiece normal microbiological method. All isolates were subjected for ESBL screening test. Antimicrobial susceptibility test was performed by Kirby.
 Results: Highest samples established from middle age group (30- 50). Out of 250 isolates, 177 (70.7%) isolates of Pseudomonas aeruginosa demonstrated zone of inhibition≤ 22 mm for Ceftazidime. All ESBL positive Pseudomonas aeruginosa isolates demonstrated elevated confrontation to ciprofloxacin 43 (91.04%), Gentamicin 34 (72.3%) and tobramycin 33 (70.21%).
 Conclusion: The majority of isolates were from hospitalized subjects which point out additional probability of their nosocomial predominance.

Cross-Sectional Study of Candidemia from Isfahan, Iran: Etiologic Agents, Predisposing Factors, and Antifungal Susceptibility Testing.

Background:Candidemia is a fatal invasive fungal infection that involves thousands of patients annually and is associated with high mortality rate and economic burden. The incidence of candidemia is increasing due to the use of invasive medical instruments and immunosuppressive drugs. The treatment of infection is problematic because of the increased resistance of clinical strains to antifungal drugs. The aim of the present study was to identify Candida species isolated from candidemia and determination of antifungal susceptibility patterns of clinical isolates.Materials and Methods:Three thousand eight hundred BACTEC bottles suspected to candidemia were evaluated from April 2019 to June 2020. For primary identification, a positive blood culture was subcultured onto the sabouraud glucose agar and CHROMagar™ Candida. For molecular identification, ITS1-5.8SrDNA-ITS2 region was amplified by ITS1 and ITS4 primers and MspI restriction enzyme was applied to digest polymerase chain reaction amplicons. Minimum inhibitory concentration of seven antifungals was determined against clinical isolates by broth microdilution method in accordance with the Clinical and Laboratory Standards Institute M27-A3 and M27-S4 documents.Results:Forty-six out of 3800 suspected specimens were positive for candidemia (1.2%). The age range of the patients was between 11 days and 89 years, with a median age of 34.8 years. Candida albicans was found to be the most Candida species (58.7%), followed by C. parapsilosis complex (19.6%), C. glabrata complex (8.7%), C. krusei (6.5%), C. famata (4.3%), and C. tropicalis (2.2%). Resistance to amphotericin B, fluconazole, itraconazole, and voriconazole was detected in 13.6%, 11.3%, 6.8%, and 4.5% of clinical isolates, respectively.Conclusion:The incidence of non-albicans Candida species is increasing that must be highlighted. Since resistant Candida strains are found repeatedly, consecutive tracing of the species distribution and in vitro antifungal susceptibility of clinical isolates is recommended for better management of infections.

Prevalence and Antimicrobial Susceptibility Pattern of Bacterial Agents Involved in Lower Respiratory Tract Infection at a Tertiary Care Hospital, Jaipur, Rajasthan, India

Introduction: Lower Respiratory Tract Infection (LRTI) is one of the commonest health problems which is not a single disease but a group of specific infections with varying aetiology and symptomatology. These infections are the leading cause of illness and mortality in children and adults across the world because of different epidemiology, pathogenesis, clinical presentation, and outcomes. Aim: To find out the prevalence, bacteriological profile and antimicrobial susceptibility pattern of clinical isolates causing LRTI. Materials and Methods: This was a laboratory based observational study which was carried out between June 2019 to May 2020. All the lower respiratory tract samples (sputum, Endotracheal (ET) aspirate, Bronchoalveolar Lavage (BAL) etc.,) were collected and sample processing was done for isolation and identification by standard methods and antimicrobial susceptibility testing was done using Kirby Bauer disc diffusion method. The data was analysed in Microsoft Office excel worksheet. Results: A total number of 1364 samples were processed in which 615 were culture positive. ET aspirates 65.04% (n=400) showed higher positivity rate than sputum 32.03% (n=197). In this study, gram positive and gram negative bacteria (GNB) were 4.23% (n=26) and 92.19% (n=567) respectively with yeast recovered in only 3.58% (n=22) of the specimens. Among the isolates, Klebsiella pneumoniae 171 (30.15%) was the most common organism. The overall susceptibility of GNB was highest towards tigecycline (51.85%) followed by gentamicin (38.62%). Conclusion: Specific antibiotic utilisation strategies like antibiotic restriction, combination therapy may help to decrease or prevent the emergence of resistance. There is a need for further community based studies to identify the best treatment protocol for individual patients.

Determination of the Antibiotic Susceptibility Pattern of Clinical Isolates of Staphylococcus aureus Collected from Various Diagnostic Centers of Dhaka City, Bangladesh

Determination of the Antibiotic Susceptibility Pattern of Clinical Isolates of Staphylococcus aureus Collected from Various Diagnostic Centers of Dhaka City, Bangladesh

Extended spectrum beta lactamase (ESBL)-producing Klebsiella pneumoniae clinical isolates and its susceptibility pattern to antibiotics at Dr. Soeradji Tirtonegoro General Hospital Klaten, Central Java

Globally, the prevalence of Klebsiella pneumoniae (K. pneumonia) producing extended spectrum beta lactamase (ESBL) has been increasing steadily. The susceptibility patterns of ESBL-producing K. pneumonia varies considerably among countries. Therefore, the investigation of ESBL-producing K. pneumoniae in clinical isolates and their susceptibility are warranted. This research aimed to determine the proportion of ESBL-producing K. pneumoniae and the antibiotic susceptibility patterns of clinical isolates from Dr. Soeradji Tirtonegoro General Hospital, Klaten, Central Java. Identification of K. pneumoniae was performed by analyzing colony morphology, microscopic examination, and biochemical testing using Microbact. Both antibiotic susceptibility testing and ESBL screening (using ceftazidime, cefotaxime, and ceftriaxone discs) were conducted using disc diffusion method according to CLSI. The positive results were confirmed with modified double disk synergy (MDDST) using amoxicillin-clavulanate, ceftazidime, cefotaxime, and cefepime discs. From 962 clinical bacterial isolates, 168 (17.46%) isolates were identified as K. pneumoniae, during June 2017-May 2018. K. pneumoniae was mainly isolated from the Intensive Care Units (ICU) (29.17%) and with sputum being the most common specimen (45.24%). Overall ESBL producers were 52.98%, with the majority from ICU (41.57%) and isolated from sputum specimens (40.45%). ESBL-producing K. pneumoniae showed high resistance to many antibiotics. The sensitivity of ESBL-producing K. pneumoniae isolated from respiratory tract samples against piperacillin-tazobactam, amikacin, and meropenem was more than 80%. In conclusion, among all K. pneumoniae isolates, ESBL K. pneumoniae was 52.98%. ESBL K. pneumoniae from respiratory tract specimens had a sensitivity of more than 80% against piperacillin-tazobactam, amikacin, and meropenem.

Antifungal Susceptibility Pattern of Clinical Isolates of Candida from a Tertiary Care Hospital in Chhattisgarh, India

Antifungal Susceptibility Pattern of Clinical Isolates of Candida from a Tertiary Care Hospital in Chhattisgarh, India

Antifungal Susceptibility Pattern of Clinical Isolates of Candida Species at Khartoum State Hospitals, Sudan

Antifungal Susceptibility Pattern of Clinical Isolates of Candida Species at Khartoum State Hospitals, Sudan

Microbiological Profile of Infections in a Tertiary Care Burns Unit.

ABSTRACTBackgroundThe burden of infections among burns patients is higher in healthcare settings due to partial or complete loss of skin as a physical barrier among these patients. We intend to present microbiological profile of patients admitted to a tertiary care hospital in South India.AimTo describe microbiological profile of infections and antimicrobial susceptibility pattern of clinical isolates from burns patients in our tertiary care hospital.Materials and methodsThis retrospective analysis was done on consecutive patients admitted with burns over a period of three years at Apollo Specialty Hospitals, a tertiary care facility in Vanagaram, Chennai. Data analysis included clinical isolates from blood, urine, tissue, pus and tracheal aspirate. Types of bloodstream infections, urosepsis and antibiogram are described.ResultsAmong 219 clinical isolates from various samples, 75% were gram-negative, 19% gram-positive and 6% were yeast like fungi. Among bloodstream infections, 32% were polymicrobial. Urosepsis was observed in 39% patients. Wound infections with sepsis was seen in 39% patients. Gram-negative isolates showed better susceptibility to amikacin, carbapenems, beta lactam – beta lactamase inhibitor combinations. Gram-positive isolates had better susceptibility to macrolides, doxycycline, glycopeptides.ConclusionThe high prevalence of gram-negative, polymicrobial infections and multidrug resistant bacteria noted in our patients and the sensitivity patterns would help with appropriate decision on initial antibiotic therapy. However escalation and de-escalation of antibiotics should be planned based on culture reports.How to cite this articleEbenezer R, Princess I, Vadala R, Kumar S, Ramakrishnan N, Krishnan G. Microbiological Profile of Infections in a Tertiary Care Burns Unit. Indian J Crit Care Med 2019;23(9):405–410.

A New Method for Determination of Minimum Biofilm Eradication Concentration for Accurate Antimicrobial Therapy.

Antimicrobial susceptibility testing (AST) is an important technique to find the susceptibility pattern of clinical isolates in order to administer the appropriate drug. One such technique is minimum inhibitory concentration (MIC), which not only identifies the right drug but also suggests the appropriate concentration necessary to neutralize the organisms in planktonic form. MIC can vary in case of adherent organisms since they form biofilms and activate survival mechanisms like quorum sensing. Here we have strategized a new method which used an inoculator plate, a resazurin dye, and a standard plate to identify minimum biofilm eradication concentration (MBEC) of adherent organisms.

Determination of Antibiotic Susceptibility Pattern of Clinical Isolates of Salmonella Typhi and Escherichia coli

Determination of Antibiotic Susceptibility Pattern of Clinical Isolates of Salmonella Typhi and Escherichia coli

Antibiotic susceptibility patterns of Uropathogenic Escherichia coli among patients with urinary tract infections in a tertiary care hospital in Maiduguri, North Eastern, Nigeria

Escherichia coli (E. coli) has been identified as the most common uropathogenic bacterial pathogen with increasing resistance to antibiotics. Aetiology of urinary tract infections (UTI) and their antibiotic sensitivity patterns vary from time to time and across different areas. In Nigeria, studies on the prevalence and antimicrobial susceptibility patterns of clinical isolates from urinary tract infections are inadequate. Employing standardised microbiological methods, this study assessed the prevalence and antimicrobial susceptibility patterns of E. coli isolates from UTI in University of Maiduguri Teaching Hospital (a tertiary health care institution) in North Eastern, Nigeria. Uropathogenic E. coli (UPEC) accounted for 150 (62.50%) of 240 urine isolates. Lowest susceptibility was for Ampicillin 54 (36.0%), Ciprofloxacin 69 (46.0%) and Norfloxacin 72 (48.0%). More than 50% were susceptible to Levofloxacin and Streptomycin 71 (54.0%) each, Cefuroxime and Co-trimoxazole 78 (52.0%) each, while highest susceptibility was for Nitrofurantoin 117 (78.0%), Chloramphenicol 105 (70.0%) and Gentamicin 96 (64.0%). The isolates were commonly resistant to 9 (24.24%) of the ten (MARI of 0.9) classes of antimicrobial agents used in this study and all the isolates were multidrug-resistant.  There is a need for proper surveillance and development of hospital specific antibiograms to inform appropriate empiric therapy of urinary tract infections.

Characterization and Evaluation of Antibiotic Susceptibility Pattern of Clinical Isolates of Methicillin Resistant Staphylococcus aureus at Some Tertiary Hospital in Kano, Nigeria

Characterization and Evaluation of Antibiotic Susceptibility Pattern of Clinical Isolates of Methicillin Resistant Staphylococcus aureus at Some Tertiary Hospital in Kano, Nigeria

In vitro synergy of antibiotic combinations against planktonic and biofilm Pseudomonas aeruginosa.

Aim: The combination of different antimicrobial agents and subsequent synergetic effects may be beneficial in treatment of P. aeruginosa infections. The aim of the present study was to determine antibiotic susceptibility patterns of clinical isolates of P. aeruginosa and the effect of different antibiotic combinations against the multidrug-resistant (MDR), biofilm-producing bacterium P. aeruginosa. Methods: Thirty-six P. aeruginosa clinical isolates were evaluated. The disk diffusion method was performed to determine antibiotic susceptibility patterns according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. The minimum inhibitory concentration of antimicrobial agents for the test organisms was determined by the broth microdilution method. To determine synergetic effects of the combinations of agents, the checkerboard assay and the fractional inhibitory concentration were used. The biofilm inhibitory concentration was determined to detect any inhibitory effect of antibiotics against the biofilm. Results: High levels of resistance were detected against most antibiotics, except colistin and polymyxin. According to the disk diffusion method, 58.3% of isolates were MDR. A synergetic effect between amikacin/ceftazidime, tobramycin/colistin and ceftazidime/colistin was found in 55.6%, 58.3% and 52.8% of isolates, respectively. A significant synergetic effect against biofilm-producing isolates was observed for the combination of tobramycin (0.5–1 µg/ml) and clarithromycin (256–512 µg/ml).Conclusion: Combinations of antibiotics have a different activity on the biofilm and planktonic forms of P. aeruginosa. Consequently, separate detection of antibacterial and antibiofilm effects of the antibiotic combinations may be useful in guiding the antibiotic therapy.

Antibiotic Susceptibility Pattern of Clinical Isolates of Escherichia coli at a Tertiary Care Hospital

Infections due to multidrug resistant E.coli range from uncomplicated urinary tract infections to life-threatening sepsis. A retrospective study was conducted to determine the patterns of antimicrobial susceptibility in 173 (12.84%) Escherichia coli strains isolated from 1347 clinical specimens of different types. Isolation and identification of E.coli were done as per routine laboratory protocol directed by Cheesbrough1. The isolation rate of E.coli was 48.57% in stool followed by 17.68% in urine, 25% in wound swabs, and 15.38% in tracheal aspirate etc. Among the 173 isolates 102 (59%) were from males and 71 (41%) were from females. Patients were classified into five age groups: 0-15, 16-30, 31-45, 46-60 and >60 years. E.coli was found highest number in females (13.9%) of age range 31-45 years and in males (22%) belonged to age group of over 60 years. Antimicrobial susceptibility testing by the disk diffusion method was conducted for 22 different antibiotics. The majority of isolated E.coli were highly sensitive to Imipenem (98.18%), Meropenem (97.37%), Amikacin (91.67%), Amoxiclav (80%), Ceftazidime (73.33%), and Gentamycin (71.76%). The antibiotics Tobramycin and Azithromycin were found as moderately sensitive against E.coli with the susceptibility rate of 52.5% and 50% respectively. The isolates show low degree of susceptibility to Penicillin G (9.52%), Carbenicillin (10%), Erythromycin (19.48%), Amoxycillin (19.59%), and Ampicillin (25%). These findings have clinical and epidemiological significance and provide a benchmark for future studies on the pattern of susceptibility of clinical isolates of E.coli in this region as well as may help the clinician to prescribe the right empirical treatment.KYAMC Journal Vol. 7, No.-1, Jul 2016, Page 681-686